Dialectical Behavioural Therapy (DBT)

Dialectical Behavioural Therapy (DBT) is a type of therapy that focuses on building up distress tolerance skills, helping you with emotional regulation, working through conflict in relationships

DBT treats a variety of mental health related concerns. It is an evidence based therapy that supports people with anxiety, depression, self-harm, substance use, addictive behaviours, Borderline Personality Disorder (BPD), relationship conflicts, suicide ideation and eating disorders.

DBT has been shown to be an effective form of treatment for people of all genders and children ages 7+, teenagers, and adults.

DBT focuses on 4 main skills:

• Mindfulness.
• Distress tolerance.
• Emotional regulation
• Interpersonal Effectiveness (relationship/conflict resolution skills)

CBT is a more general form of therapy that focuses on identifying and changing negative thought patterns and behaviours. DBT focuses more on emotions and has a strong emphasis on accepting and validating emotions while also building up coping tools for distress tolerance and focuses on emotional regulation. DBT focuses more on accepting your emotions and feelings, whereas CBT can be more focused on changing your thoughts in order to change your feelings. CBT and DBT are both important therapies that many therapists use at the same time. 

CBT is often useful for anxiety and depression, whereas DBT is helpful for both anxiety and depression as well as for borderline personality disorder, substance use, suicide ideation and self harm.

Dialectical Behavior Therapy (DBT) is based on several key concepts and principles that underpin its therapeutic approach. These concepts are essential to understanding the framework and goals of DBT:

• Dialectical Thinking: DBT emphasizes dialectical thinking, which means finding a balance between opposing ideas or concepts. It recognizes that life is full of contradictions and that individuals must learn to hold and integrate conflicting thoughts and feelings. For example, balancing self-acceptance and the need for change is a key dialectic in DBT.
• Mindfulness: Mindfulness is a core component of DBT. It involves being fully present in the moment, observing thoughts and emotions without judgment. Mindfulness skills help individuals become aware of their internal experiences and external surroundings, which is essential for emotional regulation.
• Emotional Regulation: DBT teaches individuals how to recognize and regulate their emotions effectively. This includes understanding the functions of emotions, identifying emotional triggers, and developing strategies to modulate intense emotions in healthy ways.
• Interpersonal Effectiveness: Interpersonal effectiveness skills focus on improving relationships and communication. DBT helps individuals develop assertiveness, set boundaries, and navigate conflicts skillfully, which can lead to healthier and more satisfying interactions with others.
• Distress Tolerance: Distress tolerance skills help individuals tolerate and endure intense emotional distress without resorting to self-destructive or impulsive behaviors. These skills are crucial for managing crises and preventing harmful actions.
• Validation: Validation is a fundamental aspect of DBT. Therapists strive to validate the experiences and emotions of their clients, acknowledging that their feelings are real and understandable. This validation creates a supportive therapeutic environment and encourages individuals to accept themselves and their emotions.
• Behavioral Change: While DBT emphasizes acceptance and validation, it also promotes behavioral change. It helps individuals identify problematic behaviors and develop strategies to replace them with more adaptive and effective ones.
• Commitment to Treatment: DBT requires a strong commitment from both the therapist and the individual receiving treatment. This commitment involves actively participating in therapy, completing homework assignments, and consistently applying learned skills in daily life.
• Hierarchy of Treatment Targets: DBT uses a hierarchy of treatment targets to guide therapy. The highest priority is given to behaviors that are life-threatening or self-destructive, followed by behaviors that significantly interfere with the quality of life, and then behaviors that hinder progress in therapy.
• Therapist-Client Collaboration: DBT emphasizes a collaborative relationship between the therapist and client. Therapists work with clients as partners in the treatment process, and clients are encouraged to provide feedback and express their needs and goals.
• Assessment and Progress Monitoring: DBT involves ongoing assessment to measure progress and determine whether treatment goals are being met. Therapists regularly review treatment plans and make adjustments as needed.

These key concepts form the foundation of DBT and guide therapists and clients in the process of addressing emotional dysregulation, improving interpersonal relationships, and building a life worth living. These principles and skills can be beneficial for a wide range of individuals dealing with emotional and behavioral challenges.

Yes. There have been over 30 research studies that have shown that DBT is an effective form of treatment for a variety of mental health conditions. The research has shown that DBT has been shown to be effective for treating BPD, anxiety, depression, anger self-harm, and suicidality amongst others

DBT can be very effective for people, however, everyone is different and responds differently to therapy. DBT therapy can be very helpful if you like a structured approach, want to build up your coping tools, and want to work on conflict resolution in your relationships.

Some therapists who are trained in DBT use it in alongside other types of therapy and can tailor their approach based on what your needs are and what works best for you. If you are interested in DBT and would like to know more we recommend setting up a consultation call with our therapists to talk about your needs.

DBT can be used in many ways in therapy sessions, depending on what you and your therapist have agreed on. In a more structured way, DBT can start with you and your therapist reviewing the time since you last saw one another and how you did with your specific goals. If your goals are around substance use or self-harm you may talk about how many times that happened and what happened before each time.

After talking about this your therapist may teach you some coping strategies and skills that you can use next time you have an urge for substance use or self-harm.

Some principles of DBT that are important for therapy include accountability to your therapist in your goals and discovering what barriers you encountered to achieving them and managing your emotions in the weeks previous. 

DBT can also be less structured and incorporated into other talk, art or trauma therapy. Your therapist may teach you the coping skills included in DBT as is relevant to your goals.